Approval: Doctor for Peroral Endoscopic Myotomy procedure
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Scheduling the procedure
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Pre-operative instructions to the patient
6
Patient Preparation for procedure
7
Administering anaesthesia
8
Insertion of the endoscope
9
Myotomy: cutting muscle fibers of the lower esophageal sphincter
10
Endoscope withdrawal
11
Post-operative patient monitoring
12
Assess patient's recovery and ability to swallow
13
Providing post-operative care instructions
14
Arranging post-operative check-up appointment
15
Approval: Surgeon for patient discharge
16
Documenting the procedure and post-operative follow-up
17
Communicating the overall status to the patient's primary physician
Patient consultation and symptoms assessment
During this task, you will consult with the patient to assess their symptoms and determine if they are a suitable candidate for the peroral endoscopic myotomy (POEM) procedure. Engage the patient in a friendly conversation to gather information about their medical history, any previous treatments they have tried, and the specific symptoms they are experiencing. Use your expertise to evaluate their symptoms and potential risks associated with the POEM procedure. Ensure that the patient has a clear understanding of the purpose of this consultation and its importance in aiding the decision-making process. Validate their feelings and address any concerns or questions they may have. Be reassuring and empathetic throughout the conversation.
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Mild
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Moderate
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Severe
Diagnosis and pre-procedure tests
In this task, you will perform a diagnosis and conduct pre-procedure tests to further evaluate the patient's condition. Follow medical guidelines to perform the necessary tests, such as esophageal manometry and endoscopy, to ensure the eligibility of the patient for the peroral endoscopic myotomy (POEM) procedure. Explain the purpose of each test to the patient and ensure their comfort and cooperation. Provide clear instructions regarding fasting and any necessary preparation prior to the tests. Address any concerns or questions the patient may have. Communicate the results of the tests to the patient in a compassionate manner, ensuring they understand the implications and their implications for the upcoming procedure.
Approval: Doctor for Peroral Endoscopic Myotomy procedure
Will be submitted for approval:
Diagnosis and pre-procedure tests
Will be submitted
Scheduling the procedure
In this task, you will schedule the peroral endoscopic myotomy (POEM) procedure for the patient. Use the hospital or clinic's scheduling system to find an appropriate date and time for the procedure. Take into account any specific requirements or preferences the patient may have, such as avoiding certain days or times. Communicate effectively with the patient, providing them with clear instructions on when to arrive and what to expect on the day of the procedure. Address any concerns or questions the patient may have regarding the scheduling process or the procedure itself.
Pre-operative instructions to the patient
In this task, you will provide the patient with pre-operative instructions to ensure a smooth and successful peroral endoscopic myotomy (POEM) procedure. Clearly and concisely explain the instructions, including dietary restrictions, medication management, and any necessary preparations such as fasting or discontinuing specific medications. Offer additional support by providing resources or contact information for any questions that may arise during the preparation phase. Address any concerns or questions the patient may have and alleviate their anxiety by assuring them that following the given instructions will contribute to the overall success of the procedure.
Patient Preparation for procedure
During this task, you will ensure that the patient is adequately prepared for the peroral endoscopic myotomy (POEM) procedure. Confirm that the patient has followed the pre-operative instructions, including fasting and medication management. Verify that all necessary consent forms have been signed. Ensure that the patient is wearing appropriate attire and has removed any jewelry or accessories that may interfere with the procedure. Address any last-minute concerns or questions the patient may have and offer reassurance that they are in capable hands.
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Followed
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Partially followed
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Not followed
Administering anaesthesia
In this task, you will administer anesthesia to the patient to ensure their comfort and pain control during the peroral endoscopic myotomy (POEM) procedure. Follow established protocols and guidelines for the type and dosage of anesthesia required. Communicate effectively with the patient, explaining the anesthesia process, potential side effects, and the importance of following pre-anesthesia fasting guidelines. Monitor the patient's vital signs and response to anesthesia throughout the procedure. Be prepared to handle any adverse reactions or complications that may arise during anesthesia administration.
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General anesthesia
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Local anesthesia
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Sedation
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Vital sign monitoring
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Airway management
3
Pain assessment
4
Depth of anesthesia monitoring
5
Intraoperative fluid management
Insertion of the endoscope
During this task, you will insert the endoscope into the patient's esophagus to prepare for the peroral endoscopic myotomy (POEM) procedure. Follow the established guidelines and protocol for endoscope insertion, ensuring patient comfort and safety. Explain the procedure to the patient, including the sensations they may experience and the importance of remaining still to facilitate accurate positioning of the endoscope. Communicate effectively with the patient throughout the process, addressing any concerns or questions they may have.
Myotomy: cutting muscle fibers of the lower esophageal sphincter
In this task, you will perform the peroral endoscopic myotomy (POEM) procedure by cutting the muscle fibers of the lower esophageal sphincter to treat the patient's condition. Follow the established technique and guidelines for myotomy, ensuring precision and control. Monitor the patient's vital signs and response throughout the procedure and be prepared to address any complications that may arise. Communicate effectively with the patient during the procedure, keeping them informed about the progress and ensuring their comfort.
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Vital signs monitoring
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Surgical site visualization
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Patient comfort assessment
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Electrosurgical equipment monitoring
5
Fluid management during the procedure
Endoscope withdrawal
During this task, you will safely withdraw the endoscope from the patient's esophagus following the completion of the peroral endoscopic myotomy (POEM) procedure. Follow established guidelines and protocols for endoscope removal, ensuring patient comfort and safety. Communicate effectively with the patient, informing them about the withdrawal process and any sensations they may experience. Address any concerns or questions the patient may have and provide reassurance of a successful procedure.
Post-operative patient monitoring
In this task, you will monitor the post-operative condition of the patient following the peroral endoscopic myotomy (POEM) procedure. Assess the patient's vital signs, pain level, and overall well-being according to established protocols. Ensure the patient's comfort and provide appropriate pain management as needed. Offer emotional support and reassurance to the patient and their family members. Maintain open communication with the patient, addressing any concerns or questions they may have.
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Vital signs monitoring
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Pain assessment and management
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Recovery progress tracking
4
Fluid intake monitoring
5
Patient emotional support
Assess patient's recovery and ability to swallow
During this task, you will assess the patient's recovery and ability to swallow after the peroral endoscopic myotomy (POEM) procedure. Observe the patient for any signs of complications or adverse reactions, such as difficulty in swallowing, pain, or abnormal sensations. Use established assessment tools to evaluate the patient's swallowing function and communicate the findings to the patient. Offer appropriate recommendations and interventions to support the patient's recovery and ensure their ability to resume normal swallowing.
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Observation of swallowing function
2
Evaluation of pain or discomfort
3
Use of swallowing assessment tools
4
Patient feedback on swallowing ability
5
Recommendations for improved swallowing
Providing post-operative care instructions
In this task, you will provide the patient with post-operative care instructions to promote proper healing and recovery after the peroral endoscopic myotomy (POEM) procedure. Clearly explain the instructions, including dietary restrictions, medication management, wound care (if applicable), and any activity limitations. Use engaging language to motivate the patient to follow the instructions. Address any concerns or questions the patient may have and provide comfort and support during their recovery period.
Arranging post-operative check-up appointment
During this task, you will arrange a post-operative check-up appointment for the patient to monitor their recovery progress after the peroral endoscopic myotomy (POEM) procedure. Coordinate with the scheduling department or relevant personnel to find an available date and time that is convenient for the patient. Clearly communicate the appointment details to the patient, including the purpose of the appointment and any necessary preparations. Provide contact information in case the patient needs to reschedule or has any questions or concerns.
Approval: Surgeon for patient discharge
Will be submitted for approval:
Assess patient's recovery and ability to swallow
Will be submitted
Documenting the procedure and post-operative follow-up
In this task, you will document the details of the peroral endoscopic myotomy (POEM) procedure and the patient's post-operative follow-up. Use the designated documentation system to record accurate and complete information regarding the procedure, including any notable findings or complications. Additionally, document the post-operative follow-up, including the patient's progress, assessment findings, and recommendations. Ensure that the information is clear, organized, and easily accessible for future reference and communication with other healthcare professionals involved in the patient's care.
Communicating the overall status to the patient's primary physician
During this task, you will communicate the overall status of the patient to their primary physician following the peroral endoscopic myotomy (POEM) procedure. Prepare a concise and informative report summarizing the procedure, the patient's condition before and after the procedure, and any recommendations or instructions for continued care. Ensure that the report is accurate, organized, and includes all relevant details. Address any specific questions or concerns the primary physician may have and offer further assistance if needed.
